Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2024, Vol. 20 ›› Issue (06): 603 -610. doi: 10.3877/cma.j.issn.1673-5250.2024.06.003

Original Article

Efficacy of thoracoscopic surgery for neonatal with congenital diaphragmatic hernia

Shuyu Wang1, Shiwu Yang1, Junru Chen1, Kai Chao1, Yongyu Ma1, Ya Dao1, Wei Hong1, Yunpeng Gao1, Rutao Dai1, Yaming Bai2, Xin Cao1, Jun Wu1,()   

  1. 1. Department of Cardiology,Kunming Children's Hospital,Kunming 650103,Yunnan Province,China
    2. Department of Comprehensive Surgery,Lincang City Maternal and Child Health Care Hospital,Lincang 677000,Yunnan Province,China
  • Received:2024-04-22 Revised:2024-11-20 Published:2024-12-01
  • Corresponding author: Jun Wu

Objective

To explore the therapeutic efficacy of thoracoscopic surgery for congenital diaphragmatic hernia(CDH)in newborns.

Methods

A total of 19 newborns with CDH who underwent thoracoscopic surgery at the Department of Cardiothoracic Surgery,Kunming Children's Hospital from May 2016 to April 2023 were selected as study subjects.A retrospective analysis was conducted on the clinical data of their gender,birth weight,gestational age,side of CDH,surgical treatment and surgical efficacy.The study protocol was performed in accordance with the Helsinki Declaration of the WorldMedical Association revised in 2013.

Results

The clinical data and treatment efficacy of these 19 children with CDH were analyzed as follows.①Clinical data:7 cases(36.8%)were male and 12 cases were female (63.2%).14 cases (73.7%)were left CDH and 5 cases (26.3%)were right CDH.All 19 children were born at full term,the birth weight was(3.2±0.3)kg.②Treatment strategies:Thoracoscopic surgery was performed in all 19 patients,with a median age of 4 d(2 d,7 d).The surgical time was (129.0±40.6)min,and the median intraoperative bleeding volume was 3 m L(1 m L,10 m L).The median postoperative drainage tube placement time was 7 d(2 d,48 d).③Treatment efficacy:One patient required conversion to open chest surgery during the thoracoscopic procedure.18 patients were discharged without complications,the success rate of thoracoscopic surgery in this group of pediatric patients was 94.7%.One patient developed respiratory and circulatory failure on the second day after surgery and gave up treatment;16 patients (84.2%)had a good prognosis,and 3 patients were lost to follow-up;two patients had recurrence of CDH.

Conclusions

The benefits of thoracoscopic surgery for CDH in newborns are considerable,with a low amount of blood loss,a high survival rate,and a good prognosis.

表1 本研究19例CDH 新生儿临床资料比较[例数(%)]
图1 1例CDH 患儿(男性,6个月龄)胸腔镜下带线针缝合修补膈肌裂孔操作图 图2 1例CDH 患儿(男性,14个月龄)胸腔镜下CDH 修补术切口外观图 注:CDH 为先天性膈疝
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